Friday, March 29, AD 2024 6:52am

Wishful Thinking Revisited

Following the election of Scott Brown in Massachusetts, it looked for a time as is if the passage of the recent Health Care Reform legislation was unlikely. The most common arguments aimed at moderate Democrats in the House during this time period were as follows:

1) That the Health Care reform bill would become more popular after it had passed.

2) That given widespread voter ignorance, it was unlikely that this particular vote would have much effect on any individual House member’s re-election campaign.

The first argument has long since been proven false. And now it appears the second was incorrect also:

Out of the original 50 districts, only 41 had members who cast a vote on health care reform and are running for reelection.  If we just divide these members based on their health care votes, those who voted for health reform are running 2.7 percentage points behind those who voted against it.  But, of course, we should control for other things, especially district conservatism, since those from the more conservative districts voted almost uniformly against reform.  I also included the members’ DW-NOMINATE scores to distinguish the health care vote from the members’ overall voting records.

What I found was that Democratic supporters of health care reform are running 3.2 percentage points behind Democratic opponents.  (This is statistically significant at the p?.05 level.) That’s a three percentage-point penalty resulting from a single roll call vote.  I would describe that number as large.  Most members of Congress win by much greater margins than that, of course, but for Democratic incumbents from conservative districts in a distinctly anti-Democratic year, three points is serious business.  Indeed, of the 41 Democrats I examined, only six are currently forecast to win by more than three points (and none of those voted for health care reform).

For those who supported the (ironically titled) “Affordable Health Care for America Act,” I suppose this will simply confirm that, in politics at least, no good deed goes unpunished. However, for those, like myself, who are very skeptical of the financial feasibility of the bill (or, more accurately, convinced the bill was financially irresponsible), this is a somewhat encouraging example of democratic accountability. In either case, however, it illustrates the dangers inherent in trusting the self-serving narratives of the technocratic class.

h/t: Matt Yglesias

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Morning's Minion
Tuesday, September 21, AD 2010 3:42pm

By financially irresponsible, I assume you think that it will not pay for itself and actually reduce public deficits. I assume you think that the CBO is simply wrong.

Even so, I assume you will admit that the Act at least attempts to pay for the subsidizes involved, which was not true of any of the three big Bush episodes in fiscal irresponsibility – tax cuts tilted toward the rich, war, and Medicare Part D – each of which cost more than the price tag for healthcare, and none of which was paid for.

I assume you also think that extending insurance to 32 million people is not worth the risk that the CBO might know something more than you.

Donald R. McClarey
Admin
Tuesday, September 21, AD 2010 4:10pm

What is truly telling about Obamacare is that this is the signal accomplishment of this administration, and that not one Democrat running for Congress is touting this “achievement” in campaign ads, while several Democrats are touting their opposition to Obamacare. Bloggers can say what they will, but the proof that something is truly unpopular is the total silence of the candidates of the party which passed the legislation.

http://www.gaypatriot.net/2010/09/13/is-any-democrat-running-on-obamacare-in-10/

c matt
c matt
Tuesday, September 21, AD 2010 4:51pm

By financially irresponsible, I assume you think that it will not pay for itself and actually reduce public deficits.

Am I missing something – how will it pay for itself? Raising taxes to cover it is not “paying for itself” – it is us paying for it.

Phillip
Phillip
Tuesday, September 21, AD 2010 5:00pm

Heck, even the Dems aren’t arguing anymore that it will save money and reduce the deficit:

http://www.politico.com/blogs/bensmith/0810/The_new_message_Improve_health_care_dont_talk_cost.html

Phillip
Phillip
Tuesday, September 21, AD 2010 7:12pm

Yes indeed. The Koch brothers at work. Obviously. :0

M.Z.
M.Z.
Tuesday, September 21, AD 2010 8:51pm

Polling is typically +/- 3.5% error. Add to that a likely voters model which introduces its own error, and you end up with crap like this that treats an issue as determinate that may or may not be determinate. There are so many problems with this analysis I don’t hardly know where to begin. Probably a good start would be requiring him to retake his stats course. If he would have ran the model with several other votes, we might approach having some data on what is costing people voters in certain districts. This again assumes congressional votes are determinant in elections which is hardly settled. Of course the easy way to ascertain this is to ask the poll question, “Does Congresscritter’s vote for/against health care reform make you more likely or less likely to vote for said critter?” While it wouldn’t be perfect, it would be better than trying to infer by a several weeks of polls occuring months before likely voters starting really caring about candidates.

Morning's Minion
Wednesday, September 22, AD 2010 11:00am

John Henry writes: “you actually object Bush’s record on the grounds of fiscal irresponsibility (as opposed to reflexive partisanship), I imagine that you are horrified by the Obama-era deficits.”

I am horrified by this statement. Are you at all aware why the deficits are so high? The vast majority can be explained by the Bush-era policies and the automatic stabilizers from the deepest recession since the Great Depression. I assume that not even you would propose a procyclical fiscal tighening in the midst of deep recession.

As for the old cannard on social security and medicare – yes, medicare is becoming unsustainable (social security is totally different, something the punditocracy simply don’t get). The healthcare bill takes the first step toward curbing the growth of costs, including with the Medicare commission that Republicans are demonizing (funny how they can rail against “government” healthcare and defend a single payers system tooth-and-nail at the same time, isn’t it?). In fact, most experts praise the delivery system reforms as the first ever real attempt to bend the curve here. I advise you to actually look at what is in the bill (start with the Kaiser video if that is simpler).

On costs, another points is that private insurance costs are rising dramatically more than public costs. Of course, this cost is really borne by lower wages, and so is not transparent, but it is real.

Finally,I find it dismaying that you paint pictures of phantom “rationing” while saying nothing about the scourge of rationing by cost today in uninsurance and underinsurance. Brining 32 million more people into the net is a great achievement. And yet you remain cavalier. You claim to support the goal, but you claim the means were ill-chosen. Please tell me what means you would choose. I can tell you that universal coverage pretty much always requires some form of community rating alongside an individual mandate. This is why none of the Republican proposals would not even make a dent in the number of uninsured. The laughable part is that this reform was considered pretty conservative only a decade ago – it was basically the Republican alternative to Clinton healthcare reforms, and formed the basis of Romney’s reform. But now, with the inmates running the asylum, it has been transformed from a prudential private-sector approach to a socialist conspiracy. And you call me a partisan hack.

Morning's Minion
Wednesday, September 22, AD 2010 1:06pm

John,

You are making a number of factual errors that have been debunked many times.

First, the huge long-term funding gap in entitlement program is almost exclusively medicare; social security makes up only between 15-20 percent of it, if I am remembering correctly. Social security can be fixed very easily, while bending the long-term healthcare cost curve (both public and private) is a lot harder. And you are not giving the PPACA any credit for at least taking a tentative step in the right direction.

Second, PPACA is not an entitlement. It is an mandated expansion of insurance through the private sector. You might call the subsidies an entitlement, but that twists the definition somewhat. (And anyway, if you are so worried about long-term trends, how about we agree to raise taxes on the rich and cut military spending – the two discretionary items that would have the largest budgetary impact?).

Third, you misinterpret, or misunderstand, what the CBO found on premiums. See here: http://vox-nova.com/2009/12/03/health-reform-bill-lowers-premiums/#more-11179. The bottom line is this: premiums in the small- and large-group markets (159 million people, the vast majority) will see little change (a minor reduction, in fact). In the individual market, you do see premiums rise by 10-12 percent, but the CBO goes to great pains to explain that this is all from better packages. With access to real affordable options, people are choosing higher quuality packages – this accounts for a 30 percent price increase, suggesting countervailing savings from the individual mandate and elsewhere. Oh, and if you get a subsidy, your premiums fall by 60 percent. Not a bad deal.

Fourth, you claim the Romney experiment has failed. Not so. Coverage is now close to universal, and both the individual and employer mandate are working. This reform mirrored the federal reform on access to healthcare, but not on cost control, so we won’t expect to see big savings, especially in the group markets. But there is one area where we do – the same old previously-dysfunctional individual market. Jonathan Gruber wrote a paper on this, and his conclusion is that the average individual premium fell by 40 percent, while the rest of the nation was seeing a 14 percent increase. Again, this is not bad.

jonathanjones02
jonathanjones02
Wednesday, September 22, AD 2010 1:29pm

The looming entitlement crunch is going to be brutal. Two partisan-like points that don’t seem terribly arguable, in my opinion:

Bush and the GOP were reckless in recent years, particularly with military expenditures in lives and money.

The Democrats, led by Obama, are not only bad on such measures (less so on military adventurism, more so on entitlements and deficits) they are worse.

This is one reason to wish the populist Tea Party folks well, even as I dislike populism.

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